European Primary Care Cardiovascular Society

No use of vitamin supplementation for CVD prevention, according to large meta-analysis

Supplemental Vitamins and Minerals for CVD Prevention and Treatment

Literature - Jenkins DJA, Spence JD, Giovannucci EL et al., - J Am Coll Cardiol. 2018 ; 71 (22): 2570–2584

Introduction and methods

Supplemental vitamin and mineral use is widespread, while the data on their effect on overall health and longevity is unclear. Moreover, there is no general agreement as to whether it is beneficial to take vitamins and minerals or their combinations for the prevention or treatment of CV disease. Consumption of a good diet as part of a healthy lifestyle is generally recommended. These dietary recommendations are increasingly moving towards more plant-based diets that are relatively rich in vitamins and minerals. These diets liberally provide the requirements, but stay below levels of intake that may be associated with adverse effects.

This study reviewed the evidence for supplement use over the last four years since the publication of the evidence [1] and guidelines [2] for supplement use of the US Preventive Services Task Force (USPSTF). A systematic review and meta-analysis was performed on existing systematic reviews, meta-analyses and RCTs published between January 2012 and October 2017, including the studies reviewed by the USPSTF. A total of 179 studies were included in this analysis, 15 of which were published after the USPSTF assessment.

Main results

Conclusion

This analysis showed no consistent benefit of popular supplements (multivitamins, vitamin D, calcium and vitamin C) for the prevention of CVD, myocardial infarction or stroke, or on all-cause mortality. Thus, these data do not support their continued use. Folic acid alone and B-vitamins with folic acid, B6 and B12 showed an association with a reduction of stroke. Niacin and antioxidants, on the other hand, were associated with an increased risk of all-cause mortality.

References

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